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Life Extension Magazine

LE Magazine March 2006
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Preventing Pharmaceutical-Induced Nutritional Deficiencies

By Frederic Vagnini, MD, and Barry Fox, PhD

While pharmaceuticals have lifesaving benefits, many of these medications can have serious side effects, ranging from cardiac arrest to suicide.

Millions of Americans suffer from an almost completely ignored epidemic of drug-induced nutrient depletion that can cause grave health problems. Perhaps 30% of pharmaceutical side effects are the direct result of these drug-induced nutrient deficiencies. In other words, a drug “robs” you of one or more nutrients or other helpful substances, and this lack of nutrients causes additional side effects. In a sense, the drug acts as an “anti-vitamin pill,” taking away the substances you need for good health. Thus, nutrient depletion caused by the drugs—rather than the drugs themselves—is often directly responsible for many of the side effects associated with pharmaceuticals.

Among the most common drugs linked to nutrient depletion are oral contraceptives, cholesterol-lowering statins, and antibiotics. These and many other over-the-counter and prescription medications can interfere with your body’s ability to digest, absorb, synthesize, or make use of certain nutrients, leading to nutrient deficiency-related “side effects.”

The only solution to averting drug-induced nutritional deficiencies is to replace the depleted nutrients through nutritional supplements, dietary sources, or both. In this article, we examine some commonly prescribed drugs and the vitamins, minerals, and other substances they are most likely to deplete.

ALUMINUM ANTACIDS (Gaviscon®, Maalox®, Mylanta®)

Popular over-the-counter remedies for heartburn, aluminum antacids are weak bases designed to neutralize excess stomach acid and keep it from burning the esophagus.

Which Nutrients Are Robbed

Taking aluminum antacids may deplete your supply of, increase your need for, or interfere with the activity of:

  • vitamin A
  • folic acid
  • vitamin D
  • calcium
  • chromium
  • iron
  • magnesium
  • phosphorus
  • zinc.

Restoring the Nutrient Balance

Speak to your physician about taking 5000 IU of vitamin A, 800 mcg of folic acid, 1000-2000 IU of vitamin D, 1200 mg of calcium, 700 mcg of chromium, 1500 mg of magnesium, and 50-100 mg of zinc. Ask your physician to consider the potential effects of iron and phosphorus depletion. You can also eat foods that contain the depleted nutrients.

ATENOLOL (Rhoxal-atenolol®, Tenolin®, Tenormin®)

Atenolol is a beta-blocker used to treat angina and elevated blood pressure, prevent migraines, and reduce the odds of further complications in those who have had a heart attack.

Which Nutrients Are Robbed

Taking this medicine may deplete your supply of, increase your need for, or interfere with the activity of:

  • coenzyme Q10
  • melatonin.

Restoring the Nutrient Balance

To compensate for the nutrient loss caused by this drug, speak to your physician about taking 100-300 mg of coenzyme Q10 and 1-3 mg of melatonin. You can also eat foods that contain the depleted nutrients.

CIPROFLOXACIN (Cipro®, Ciloxan®)

Ciprofloxacin is an antibacterial agent used to treat infections of the urinary tract, lower respiratory tract, sinuses, and other parts of the body.

Which Nutrients Are Robbed

Taking this medicine may deplete your supply of, increase your need for, or interfere with the activity of:

  • biotin
  • inositol
  • thiamin
  • riboflavin
  • niacin
  • vitamin B6
  • vitamin B12
  • vitamin K
  • zinc
  • Bifidobacteria bifidum
  • Lactobacillus acidophilus.

Restoring the Nutrient Balance

Speak to your physician about taking 500-1000 mcg of biotin, 250-1000 mg of inositol, 25-200 mg of thiamin, 25-100 mg of riboflavin, 50-100 mg of niacin, 100 mg of vitamin B6, 500-1000 mcg of vitamin B12, 1-10 mg of vitamin K, 50-100 mg of zinc, 15 billion live Bifidobacteria bifidum organisms, and 15 billion live Lactobacillus acidophilus organisms. You can also eat foods that contain the depleted nutrients.

COLESEVELAM (WelChol®)

Colesevelam is used to treat elevated cholesterol, either by itself or in conjunction with a statin drug.

Which Nutrients Are Robbed

Taking this medicine may deplete your supply of, increase your need for, or interfere with the activity of:

  • beta-carotene
  • folic acid
  • vitamin A
  • vitamin B12
  • vitamin D
  • vitamin E
  • vitamin K
  • iron

Restoring the Nutrient Balance

Speak to your physician about taking 25,000 IU of beta-carotene, 800 mcg of folic acid, 5000 IU of vitamin A, 500-1000 mcg of vitamin B12, 1000-2000 IU of vitamin D, 400 IU of vitamin E, and 1-10 mg of vitamin K. Ask your physician to consider the potential effects of iron depletion. You can also eat foods that contain the depleted nutrients.

ETHINYL ESTRADIOL plus NORGESTREL (Ovral®, Lo/Ovral®, Low-Ogestrel®)

Commonly known as the birth control pill, this combination of synthetic estrogen and progestin is used to prevent ovulation and thus prevent pregnancy.

Which Nutrients Are Robbed

Taking this medicine may deplete your supply of, increase your need for, or interfere with the activity of:

  • folic acid
  • magnesium
  • tyrosine
  • riboflavin
  • niacin
  • vitamin B6
  • vitamin B12
  • vitamin C
  • zinc

Restoring the Nutrient Balance

Speak to your physician about taking 800 mcg of folic acid, 1500 mg of magnesium, 250-500 mg of tyrosine, 25-100 mg of riboflavin, 50-100 mg of niacin, 100 mg of vitamin B6, 500-1000 mcg of vitamin B12, 250-1500 mg of vitamin C, and 50-100 mg of zinc. You can also eat foods that contain the depleted nutrients.

FAMOTIDINE (Pepcid®, Pepcid® AC)

Famotidine is used to treat certain types of gastritis, gastric and duodenal ulcers, gastroesophageal reflux disease (GERD), heartburn, and related conditions by reducing the amount of acid produced by the stomach lining.

Which Nutrients Are Robbed

Taking this medicine may deplete your supply of, increase your need for, or interfere with the activity of:

  • folic acid
  • thiamin
  • vitamin B12
  • vitamin D
  • calcium
  • iron
  • zinc

Restoring the Nutrient Balance

Speak to your physician about taking 800 mcg of folic acid, 25-200 mg of thiamin, 500-1000 mcg of vitamin B12, 1000-2000 IU of vitamin D, 1200 mg of calcium, and 50-100 mg of zinc. Ask your physician to consider the potential effects of iron depletion. You can also eat foods that contain the depleted nutrients.

FLUOXETINE (Prozac®)

Prozac®, the first in the family of drugs called selective serotonin reuptake inhibitors (SSRIs), works by increasing the levels of serotonin in the brain to treat depression, obsessive-compulsive disorder, panic disorder, and bulimia nervosa.

Which Nutrients Are Robbed

Taking this medicine may deplete your supply of, increase your need for, or interfere with the activity of:

  • melatonin

Restoring the Nutrient Balance

To compensate for the nutrient loss caused by this drug, speak to your physician about taking 1-3 mg of melatonin each night.

GLYBURIDE plus METFORMIN (Glucovance®)

A combination drug used to treat diabetes, glyburide stimulates the pancreas to produce larger amounts of insulin, while metformin helps remove excess glucose from the blood while slowing the release of additional glucose.

Which Nutrients Are Robbed

Taking this medicine may deplete your supply of, increase your need for, or interfere with the activity of:

  • folic acid
  • vitamin B12
  • sodium
  • coenzyme Q10

Restoring the Nutrient Balance

To compensate for the nutrient loss caused by this drug, speak to your physician about taking 800 mcg of folic acid, 500-1000 mcg of vitamin B12, and 100-300 mg of coenzyme Q10. Ask your physician to consider the potential effects of sodium depletion. You can also eat foods that contain the depleted nutrients.

HYDROCODONE plus ACETAMINOPHEN (Hydrogesic®, Lortab®, Vicodin®)

Hydrocodone is an opioid painkiller that, like morphine, works by imitating the body’s own endorphins. Acetaminophen slows the production of the prostaglandins that “encourage” pain.

Which Nutrients Are Robbed

Taking this medicine may deplete your supply of, increase your need for, or interfere with the activity of:

  • glutathione
  • selenium

Restoring the Nutrient Balance

To compensate for the nutrient loss caused by this drug, speak to your physician about taking 600-1200 mg of N-acetylcysteine, a precursor to glutathione, along with 200 mcg of selenium.

MAGNESIUM HYDROXIDE (Phillips® Milk of Magnesia)

Magnesium hydroxide is an osmotic laxative that encourages the movement of fluid into the colon, which helps to soften the stool and stimulate the action of the bowels.

Which Nutrients Are Robbed

Taking this medicine may deplete your supply of, increase your need for, or interfere with the activity of:

  • folic acid
  • vitamin D
  • calcium
  • iron
  • phosphorus
  • zinc

Restoring the Nutrient Balance

Speak to your physician about taking 800 mcg of folic acid, 1000-2000 IU of vitamin D, 1200 mg of calcium, 700 mg of phosphorus, and 50-100 mg of zinc. Ask your physician to consider the potential effects of iron depletion. You can also eat foods that contain the depleted nutrients.

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